Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 6637 | TN |
NPI | 1013435718 |
---|---|
Provider Name | Chandler Elise Coleman |
First Address | Memphis, TN 38120-4023 |
Second Address | Memphis, TN 38120-4023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2017 |
Last Update Date | 01/09/2017 |